An Ounce of Prevention, worth a pound of Treatment

I just barely came from the dermatologist's office. In fact, it was exactly 13 minutes ago. (My office is but a mere block away from my dermatologist's office - how perfectly convenient, especially when you're a patron of the public transit system.) Ironically, this visit to the dermatologist landed during our 1st Annual Dermatologists' Appreciation Week (this was not planned, by the way, though it definitely reeks of me.) Actually, I have been meaning to go the dermatologist for weeks. Every time I scheduled an appointment, some all-too-important project with an insanely pressing deadline would come up at work (you know, my "real job"; the one that pays the bills, because skin cancer crusading, though my life's mission, is what I do in my spare time - voluntarily). And, as such, I would have to cancel my dermatologist's appointment. Fortunately, the two new moles I found while performing my monthly self-skin exams didn't look atypical or suspicious; however, the sheer fact that they were new was cause for concern. Finally, my dermatologist called me on my cell phone and said "No matter what time of the day, I'll be available to get those moles taken care of, Danielle." In other words, "Drag your hind parts on over here, Danielle, NOW!"

And I did.

This morning, after getting out of the shower, I performed my monthly self-skin exam for September. I wanted to double-check those two new moles that I found earlier and examine all my other moles. I, thanks to both my mother and father, have numerous dysplastic (abnormal) moles and a high-risk for melanoma skin cancer. Additionally, melanoma is most common among women in their 20s and 30s, and since I'm 28 -- and a skin cancer educator, I wanted to be thoroughly prepared for my dermatologist's visit today. It was wise to examine my moles this morning. It turns out that one of the new moles I found (on my right thigh) had changed. In fact, it had grow rather large. And since ANY change in a mole - whether it be a previous mole or a new one - is a red flag, it was a good thing that I was going to get it cut off and biopsied today. Moreover, the other new mole (located behind my left knee), though it hadn't grown laterally across my skin, it apparently had burrowed beneath the epidermis (top uppermost part of the skin - the layer you can see) and the dermis (the layer skin just below) and into the subcutaneous tissue (the third layer of skin that contains fat and connective tissue and houses the larger blood vessels). YIKES! A mole that's burrowing beneath the skin and into the subcutaneous tissue is definitely cause for concern.

"Boy, am I so very glad you came in today and asked me to look at this mole on your leg, Danielle. It's deep. It definitely needs to be biopsied. The mole on your hip - the one that you said was changing, wasn't very deep, but it's definitely going to the lab. By the way, Danielle. Since I saw you last (in April), I have removed three melanomas off of women who are also in their 20s! I also removed a couple of suspicious moles off a little girl."

Then, Carrie the dermatologist, proceeded to excise an additional mole on my back.

"There is another one on your back, and that one on your left shoulder that you mentioned that I want to take care of when you come back in two weeks to get your stitches removed," she said. "In the meantime, these are going to lab."

"We caught the one on my leg early enough that it won't be an issue, right?" I asked.

"More than likely, the lab reports will come back clean like the others. Yet, if you hadn't come in today, I might be telling you something different. We may have had an issue on our hands," she said. "But, I know how vigilant you are about checking your skin, protecting yourself from the sun. I mean, you're the skin cancer crusader. You're apart of the American Academy of Dermatology! I don't worry too much about you delaying action on something suspicious. I'm just glad that my schedule was finally in-sync with yours so we can get this taken care of early, before it became something more serious."

(Did I mention that my dermatologist stayed after hours just to accommodate me? Oh, and yes, she even gave me her cell phone number so that I could call her "anytime day or night, if I have a concern about another mole" or if the excision spots "don't heal quickly and there's any sign of infection" Truly, this is a dermatologist who cares about her patients. And, it's an added blessing to have my dermatologist has become my friend. In fact, she wanted to know if I'd be in Vegas for the AAD meeting so we could "hang out together!")

Wow! Reflecting back on it all, I can't help but think...

If I had ignored it or dismissed it as "nothing" (which I sort of thought it was "nothing" except that it was new, and it was larger than 6mm), I may be facing more than a series of stitches and some soreness; rather, a possible melanoma diagnosis.

Ah, yet another testament to the necessity of monthly skin exams, as well as the importance of being willing to open your mouth and ask your dermatologists those important questions! Indeed, an ounce of prevention is worth a pound of treatment. (I talk a lot about ways to build a relationship with your dermatologist and being your own best advocate in my book ONLY SKIN DEEP?)

With that, take a few minutes today, after getting out of the shower, to perform a thorough self skin exam. Take digital photos of your moles and start cataloging them to monitor any potential changes over time. (Don't forget to print these photos off, date them and catalog them). Get your spouse to help you out with those hard to reach places such as your back, backs of your legs and even your scalp (a common place for melanomas to appear). Write down any questions and concerns you may have for your dermatologist in a notebook and bring it with you to your next appointment. (I suggest keeping a record of all your dermatologist's visits - date, what happened during the appointment, and keep that information in the same notebook along with your questions and photos.)

It is just too important; you can't neglect your skin (or your body, in general). Remember - an ounce of prevention is worth a pound of treatment.

Here here.

Yours in the fight,
Danielle & The Cancer Crusaders Organization

(Note: Pictures of those moles Dr. Carrie removed today will be coming shortly).



PS: Ladies, here's an idea - since we all be going in for our annual mammograms next month (to commemorate Breast Cancer Awareness month), why don't you book an appointment with the dermatologist for your annual full body skin exams, too. This way, you're fighting off two deadly cancers in one month! Remember, breast cancer is important (I know, it killed my mother)and so is melanoma skin cancer. In fact, melanoma skin cancer is the only cancer that's on the rise. Yet, it's SO PREVENTABLE IF WE ARE PROACTIVE!

So, be proactive. Protect yourself. Check out your birthday suit and save your skin (and ultimately your life).

"Do-Gooder" Companies Supporting the Fight against Skin Cancer

In most cases, I generally avoid perceived endorsements. As the co-founder of 501 [c] [3] non-profit skin cancer education facility, I want to be doubly sure that our efforts to educate youth and communities about sun safety and skin cancer prevention are done with pure intent. Those of us who are members of The Cancer Crusaders Organization volunteer our time, outside of full-time jobs and grad school, because we are passionate about protecting people from skin cancer. This cause is so near and dear to our hearts. We bleed orange-n-yellow for Skin Cancer Awareness!

Yet, who is to say that only non-profit organizations can contribute, with pure intent, to the fight against cancer? There are a few companies out there who are generously donating time, money, energy, resources and even their heart and soul toward protecting people, especially youth, from the world's most common cancer.

I would like to give a huge heartfelt round-of-applause to two such companies:

First, I would like to thank SKYShades of Florida. I recently received an email that told me about the wonderful contributions SKYShades has made toward building shade structures for Florida elementary schools. Here's the press release that was sent to me about SKYShades:


_______________________________________________________________________
BUSINESS DONATES $50,000 TO HELP IN THE PREVENTION OF SKIN CANCER!
_______________________________________________________________________


One Florida business is playing an active role in educating and building awareness on the importance of providing shade for children. SKYShades have donated two shade structures (totaling more than 50K!) to two lucky schools, Millenia Elementary in Orlando and Lyman High School in Longwood, Florida. Robert Black, Assistant Principal of Lyman High School, is over the moon with this donation - he says "Not only is it extremely serviceable [but] it looks fantastic!"

SKYshades, headquarted in Orlando, has helped many schools design and construct custom shade structures to protect their pupils from the scourge of skin cancer. "Our efforts here at SKYShades are to do all we can to increase awareness as well as promote prevention through the use of shade." says Joe McKenna, Executive VP of SKYShades.

Children between the ages of 2-4 are particularly vulnerable and with solar radiation being most intense from 10:00 AM and 4:00 PM, the prime hours when youngsters and school personnel are outdoors on campus (during PE, recess & lunch), schools /child care centers and all education facilities need to take a more proactive stance in helping to curb this epidemic.

"Everyone in Florida needs to be aware of the potential harm that sun exposure can cause to us and our children,” says Vernon Sondak, M.D., chief of the Cutaneous Oncology Program at H. Lee Moffitt Cancer Center in Tampa. “We actively support efforts to increase sun awareness and sun protection. Sunscreens are only a part of sun protection - but they are an important part. It is important to remember that most of our lifetime sun exposure occurs before age 18, so it is vital to teach your children good sun habits and protect them from sun damage as they grow."


In Australia, by Law, education facilities MUST provide shade for their students and this is something that the American government needs to consider here especially since melanoma is the only cancer that continues to increase each year.

All of SKYShades shade structures are designed and engineered for local wind codes and not only are they functional, but are also aesthetically pleasing.

SKYShades donates $100,000 annually toward building shade structures in communities throughout Florida.

###


That said, I would like to publicly praise Del-Ray Dermatologicals (the manufacturers of Blue Lizard Australian Suncream) for the tremendous amount of support they have given to skin cancer prevention over the years. In addition to supporting our effort to distribute copies of the ONLY SKIN DEEP? An Essential Guide to Effective Skin Cancer Programs and Resources to skin cancer foundations and universities in high-risk states (the next edition will coming early 2008 and distributed accordingly), the CEO of Del-Day Dermatologicals spearheaded the "Sun Safe School" contest with the SHADE Foundation and has personally dedicated his life toward raising awareness for skin cancer. I have met Jeff, personally, and I'm a passionate Blue Lizard Suncream fan! Moreover, Del-Ray Dermatologicals continues to coordinate and collaborate with various organizations, including the Women's Dermatologic Society and the American Academy of Dermatology, in providing education, support, and advocacy on behalf of skin cancer prevention education!

That said, I would also like to thank UVSkinz, a new sun protection clothing company run by a woman who lost her husband to melanoma skin cancer, for contacting The Cancer Crusaders Organization about our children's book - SKIN SENSE (written by our friend Lori Glickmann) which is coming out October 8th. We will be distributing copies of SKIN SENSE to all the melanoma skin cancer foundations throughout the country to help teach parents and children about the importance of proper, lifelong sun safety.

If you know of a "Do-Gooder" - a skin cancer crusader (an individual or an organization) who is championing the cause of skin cancer prevention education, please feel free to email me at info@cancercrusaders.org

Three cheers to all our skin cancer heroes and champions!

Yours in the fight,
Danielle & The Cancer Crusaders Organization

(Note: The picture above is of the shade structure SKYShades built for Millenia Elementary in Florida).


--

Here's another company who is doing incredible work on behalf of skin cancer prevention/sun safety:



Business spotlight on Sun Smart PR

Owner: Missy Varner

Location: Home-based business in Bluegrass/Concord

Contact: 865-693-0915, 865-414-4985 or missyvarner@gmail.com

Web site: www.sunsmartpr.com


Today there are a variety of products, in addition to sunscreen, to protect you and your family from the sun's damaging UV rays, and Missy Varner is helping get the word out about them with her home-based business, Sun Smart PR.

A former teacher, Varner learned about sun-protective clothing while searching for clothing for her daughters - Abbey, 8, and Emily, 7 - on the Internet. A Web site looking for sales representatives for a sun-protective clothing company caught her eye, and she realized this could be her "niche."

"I knew I wanted to be a stay-at-home mom who could help at my daughters' school and go on field trips, but I also wanted to do something I thought was meaningful but still allowed me to be available for the girls," said Varner, 37.

That was in 2004. Varner now represents 11 companies, all from the comfort of her Bluegrass/Concord home.

"I'm their middle man," Varner explained. "They send me samples, and I contact stores and take them the lines and show them. Then the stores place their orders."

Varner also helps publicize the companies by sending their press kits to parenting magazines and other media. Recent clients have been featured in national publications such as "Child," "Parenting," "Ladies Home Journal," "In Style" and "Parents."

"I'm not trying to compete with big PR firms; I only take companies in sun protection," she noted.

Sun protection includes everything from clothing and accessories to sunglasses and sunscreens, Varner said. She has a personal interest in the products because she and her husband, Mike, a director of engineering, are avid boaters, out on the lake every weekend when the weather is nice.

"I am very careful to protect my family from (the sun)," she said. "I always have researched sunscreen because I don't want to put something harmful on my kids."

Now the Varner family - and their friends - wears sun-protective clothing as well as sunscreen. Boasting a tight weave, a good fabric can block 45-55 percent of UV rays, Varner said.

The companies Varner represents offer clothing for men and women, boys and girls, infants to plus sizes. But as a mom to Abbey - who believes that "everything head to toe has to match" - Varner knows the importance in choosing clothing that your children are going to want to wear. The swimwear, for instance, is lightweight and dries quickly, plus it comes in "fun patterns" with pieces to mix and match.

"These modern products not only look fantastic, they also offer unbeatable protection against sun damage," Varner said. "Sun-protective clothing designers are revolutionizing the industry - they're making a fashion statement that actually saves lives."

"While sun-protective clothing has been popular in Australia for at least 20 years, the concept is just catching on the United States", Varner said. "Out West, sun-protective clothing is finding its way into major department stores, but here, it's more boutique-driven", she added.

"This isn't so well-known yet, so I get to educate (the public) on something worthwhile," she said.

After all, the American Academy of Dermatology and the American Cancer Society estimates that one in five Americans will face a diagnosis of skin cancer at some point, Varner noted.

"Most of the people I work for have been touched by skin cancer, and they all are doing this to raise awareness," she added. "One is a melanoma survivor who decided to develop a line of children's clothing."

Varner travels to trade shows and is considered an online expert on the subject of sun-protective products, she said. In addition to holding online seminars, Varner is open to speaking to local groups as well.

The biggest challenge, she said, is getting people to understand that it's no longer smart to shun sunscreen in favor of a tan.

"People still want that summer glow, and it's hard to get their minds to go the other way," Varner said.

Armed with awareness and education, though, Varner is working toward her goal.

"I would like to see sun-protective clothing in any store you go into," she said. "I want it to be just like a pair of jeans."

###

Sneak Peak: Skin Sense, a book for children

The Cancer Crusaders Organization is pleased to announce the forthcoming debut of Skin Sense.

Written by our friend Lori Glickman a licensed clinical social worker and mother of three young daughters, Skin Sense is the first children's book (illustrated by a Glickman's 10-year-old daughter) that discusses the importance of lifelong sun safety and includes fun, interactive tips for year-round sun protection.

"This book was written with hopes of generating the desire in young children to want to protect their skin from the sun and for parents and teachers to want to protect their children," Glickman says. "Each child who is properly protected daily from the sun everyday is one less potential skin cancer statistic in our future.”

According to the American Academy of Dermatology, 80% of one's lifetime sun damage occurs before age 18. Skin Sense addresses the urgent need for parents, caregivers, and educators to teach children how to properly protect themselves from over-exposure to harmful UV rays. This book is an essential tool in the constant effort to teach children about sun safety and to significantly reduce the number of young adults in their 20s and 30s being diagnosed with melanoma--the deadliest form of skin cancer.

This is what dermatologist Katherine Bell of Houston, Texas had to say about Skin Sense:

" [Skin Sense is] An accurate and important book, which grabs the attention of its young audience and impels them to want to protect their skin.”


Thanks, Lori, for writing such an important and much-needed book! Skin Sense is a must-have for any parent, grandparent, skin cancer crusader -- anyone who loves children and wants to protect them from this growing form of cancer.

Pre-order your copy of Skin Sense today by clicking on the icon button below:

The Cancer Crusaders Organization will be distributing copies of Skin Sense to skin cancer foundations across the nation. (More information to come soon.) In the meantime, if you have any children in your life - daughters, sons, nieces, nephews, friends, and neighbors -- this is the perfect book to help these children adopt a life of SunSavvy behavior; to protect them from the world's most common cancer. The holidays are coming soon, so get a copy of Skin Sense and make it a life-saving gift.

To be the FIRST to order a copy of Skin Sense from The Cancer Crusaders Organization, send an email to info@cancercrusaders.org. All proceeds will support the fight against skin cancer! (All payments are secure through PayPal and are tax-deductible).

As always, here's to being SunSavvy!
Danielle M. White, co-founder/president
The Cancer Crusaders Organization
& author of ONLY SKIN DEEP?

*Note: Official press release will come shortly. This is a sneak preview offered exclusively through The Cancer Crusaders Organization, a registered 501 [c] [3] non-profit skin cancer education facility. For more information or to make a donation, please contact us or send an email to info@cancercrusaders.org. Thank you for supporting the fight against skin cancer.

Understanding Ultraviolet Radiation and the necessity of a quality Sunscreen

Since I wrote about Justice Roberts' stance on FDAregulations regarding sunscreen, I have received a variety of emails that indicate a general misunderstanding of sunscreens; how sunscreen works and why a quality broad-spectrum sunscreen is, in fact, a crucial part of savvy sun protection and reducing your risk for skin cancer.


So, here are some additional facts about sunscreens to reemphasize the the importance of regulating sunscreens; ensuring that manufacturers produce only the best, most effective sunscreens to provide optimum protection against ultraviolet radiation, and holding them accountable to the claims they make regarding the effectiveness of their sunscreen products.

Sunscreen Fact Sheet - Part II
FDA monograph and Australian sunscreen standard

(Note: The Australian standards on sunscreen efficacy are considered the strictest in the world. They require sunscreens have a minimum 5% zinc oxide and a minimum 5% titanium dioxide so as to reflect/deflect UVA and UVB rays from damaging your skin.)

What are sunscreens?
Sunscreens are products that protect the skin from damage caused by ultraviolet radiation (UVR). They do this by using organic chemicals that absorb light and dissipate it as heat, as well as inorganic filters (blockers) that sit on the surface of the skin and act as physical barriers; or a combination of both.

Ultraviolet Radiation
There are three types of UVR:
• UVB - primarily responsible for sunburn and suntan. Long-term exposure leads to premature aging of the skin and skin cancer.
• UVA - primarily responsible for premature aging and skin cancers like melanoma and basal cell carcinoma.
• UVC - is absorbed by the earth's atmosphere.

What protection do sunscreens provide?
SPF 30 sunscreens filter 97% of UVB rays. In Australia, broad-spectrum sunscreens must protect against 95% of UVA rays. In the United States, there is no approved evaluation of UVA protection, therefore "broad-spectrum" labeling is open to interpretation. Consumers should be educated on the ingredients that provide UVA protection. Products that contain 5% or more zinc oxide provide excellent UVA protection.

Key points about sunscreens:

• No sunscreen is entirely waterproof/sweatproof. Sunscreen should always be applied to dry skin. All sunscreens start to come off during activity, therefore it is important that sunscreen be reapplied after towel drying. Products labeled as "waterproof" in the United States have completed an 80-minute still-water bath test. Products labeled as "very water resistant" in Australia retain their SPF after 240 minutes in moving water. Australia does not allow the use of "waterproof" or "sweatproof," and the FDA has asked for voluntary removal of such labeling on sunscreens here. In reality, it should be a mandatory removal of such labeling because it misleads consumers! (Note: Blue Lizard sunscreen says "very water resistant" by Australian standards).

• No sunscreen provides "all-day protection." As stated previously, chemical absorbers work by absorbing light, but they can be photo (sun)unstable. For example, Avobenzone loses 36% of its effectiveness within the first 15 minutes of sun exposure. Inorganic filters (zinc oxide and titanium dioxide) adhere to the skin but can be removed during towel drying. Australia does not allow the use of "all-day protection." Moreover, the FDA has asked for voluntary removal of this label claim. This is why it is so important to reapply sunscreen. Not only does your skin, acting akin to a sponge, reach its saturation point after about two hours thus requiring another layer of sunscreen to be applied, reapplication helps maximize your sunscreen efficacy.


• High SPF sunscreens do not necessarily offer broader or better protection. SPF only indicates the amount of UVB protection a product provides and does not indicate how much if any UVA protection is provided. The consumer needs to understand that the specific formulation of the sunscreen determines the amount of protection provided. Zinc Oxide products (5% or higher) provide very photostable UVB and UVA protection. High SPF products (i.e. SPF 45, 55, 60) typically contain high levels of organic chemicals that can increase the potential for irritation and absorption, especially in children. Higher is not always better, which is why Australia limits SPF label claims to 30. If you consider that a SPF 20 is preventing 95 out of every 100 UV protons from penetrating your skin, than a SPF provides excellent protection. The American Academy of Dermatology recommends SPF 30.

• No sunscreen offers complete 100% protection against the sun. Therefore products using the term "sunblock" are a misnomer as they allow some UV to penetrate the skin. A product that contains zinc oxide does provide blocking (reflective) capabilities but even zinc oxide, unless applied as a paste, allows a little UV light to penetrate the skin.

With that, it is important to understand how ultraviolet radiation works so as to further illustrate the seriousness of UV exposure (especially from tanning), it's direct link to an increased risk for skin cancer (and the fact that skin cancer is the most common cancer in the world), hence the importance of sun safety and proper use of a quality SPF 30 sunscreen.

Furthermore, I have (with the help of the Environmental Protection Agency, the AAD, and ARPANZA and my good friend, Kathleen, a physicist at the University of Nova Scotia) compiled a list of common questions people ask about ultraviolet radiation, how it works, and its link to skin cancer:


Understanding Ultraviolet Radiation - Q&A


Q. What is solar ultraviolet radiation?

A. Ultraviolet radiation (UVR) is defined as the portion of the electromagnetic spectrum between 100 nanometers (nm) and 400nm. Ultraviolet radiation is classified by wavelength into three regions: UVA - Ultraviolet radiation in the range 315nm to 400nm is thought to contribute to premature aging and wrinkling of the skin and has recently been implicated as a cause of skin cancer. UVB - Ultraviolet radiation in the range 280nm to 315nm is more dangerous than UVA and has been implicated as the major cause of skin cancers, sun burns, and cataracts. UVC - Ultraviolet radiation in the range 100nm to 280nm is extremely dangerous but does not reach the earth’s surface due to absorption in the atmosphere by ozone.


Q. How are people exposed to UVR?

A. Solar UVR is the single most significant source of UVR and can reach a person on the ground from three sources, directly from the sun, scattered from the open sky and reflected from the environment. This means that even if a person is shaded from the direct sun they can still receive substantial UVR exposure from the open sky. Also some ground and building surfaces are quite reflective to UVR including white paint, concrete and metallic surfaces. These surfaces can reflect UVR onto the skin and eyes. Reflective surfaces can reduce the effect of protective measures. There are also many types of artificial UVR sources, some of which emit high levels of UVR. Arc welders used in industry produce an intense UVR emission and workers exposed to welding radiation may suffer similar health effects to workers with over exposure to solar UVR. There are many other forms of artificial UVR sources such as fluorescent lamps, mercury vapor, metal halide and quartz halogen lamps used in industry, offices and in the home.

Q. How is UVR measured?

A. Broadband UV biometers and pyranometers are generally used to measure or monitor solar UVR. These instruments measure global solar UVR received on a horizontal surface from the entire hemisphere of the sky. Solar radiation includes both UVR transmitted directly and scattered UVR from the atmosphere, so the design of these instruments ensures measurement of both direct and diffuse radiation. These instruments can also be used to monitor changes in ozone levels and cloud cover effects by measuring changes in UVR irradiation levels.


Q. What are the effects of exposure to UVR?

A. The major organs at risk from exposure to UVR are the skin and eyes as the penetration depth of UVR is very short. Ultraviolet radiation can be produced by various artificial sources but for most people the sun is the predominant source of UVR exposure. For outdoor workers without adequate protection or control measures the levels of solar UVR may exceed the generally accepted exposure limits. Those who have been over-exposed to UVR may be unaware of their injury as UVR cannot be seen or felt and does not produce an immediate reaction. Over-exposure to UVR can cause sunburn, skin damage and skin cancer. The most obvious short-term effect of over-exposure to UVR is sunburn. The more UVR exposure, the worse the sunburn becomes. A person’s cumulative exposure to UVR along with the number of severe sunburns they have received, especially during childhood, increases their risk of developing skin cancer. Sun exposure causes the outer layers of the skin to thicken and long-term exposure can cause skin to wrinkle, sag and become leathery. Melanoma, the least common of the skin cancers but the most dangerous, may be related to severe exposure to solar UVR at an early age. Malignant melanomas may appear without warning as a dark mole or a dark “spot” on the skin. UVR exposure also places our eyes at risk of photokeratitis, photoconjunctivitus, ocular melanoma, and cataracts. Cataracts is one of the most common types of eye damage in Australia. Cataracts is the clouding of the lens of the eye, which is responsible for focusing light and producing sharp images. Without intervention, cataracts can lead to blindness.

Q. How can I reduce my risk from UVR exposure?

A. Increasing public awareness and interest in UV protection is due in part to the requirements for occupational protection of outdoor workers as well as the provision of UVR protection for the recreational market. Behavior outdoors can significantly affect a person’s solar UVR exposure and use of items of personal protection can provide a substantial reduction in the UVR dose received. Many forms of personal protection are available to reduce a person’s exposure to solar UVR. The best protection is to avoid peak hours of 10:00 AM and 4:00 AM when the sun's rays are most intense, coupled with proper sun protection year-round (even on cloudy and cold days). When outdoors, wear sun protecting clothing with good body coverage (that is rated at UPF 30-50+), a wide-brimmed hat, UV protective sunglasses and a SPF 15+ sunscreen. Over recent years interest has extended to shade structures and the UVR protection offered by commonly used materials such as shadecloth, plastic roofing materials, glass and window tinting films, even specially manufactured sun protective clothing.



Q. What is the UV Index?

A. Some exposure to sunlight can be enjoyable; however, too much could be dangerous. Overexposure to the sun's ultraviolet (UV) radiation can cause immediate effects such as sunburn and long-term problems such as skin cancer and cataracts. The UV Index, which was developed by the National Weather Service and the U.S. Environmental Protection Agency (EPA), provides important information to help you plan your outdoor activities to prevent overexposure to the sun’s rays. The UV Index provides a daily forecast of the expected risk of overexposure to the sun. The Index predicts UV intensity levels on a scale of 1 to 11+, where low indicates a minimal risk of overexposure and 11+ means an extreme risk. Calculated on a next-day basis for every ZIP code across the United States, the UV Index takes into account clouds and other local conditions that affect the amount of UV radiation reaching the ground in different parts of the country.

UV Index Number Exposure Level
0 to 2 Low
3 to 5 Moderate
6 to 8 High
8 to 10 Very High
11+ Extreme


In closing this post, I assure you that I will continue to address the issue of proper sunscreen usage, sun safety, tanning, and other proven-effective methods of skin cancer prevention. With 90-95% of skin cancers resulting from over-exposure to ultraviolet radiation from the sun and tanning, skin cancer is largely preventable. Yet, in order to prevent skin cancer we must take proactive measures to protect ourselves and youth from it. The media and society, as a whole, may not recognize the seriousness of skin cancer and how incidence is growing at epidemic rates; however, I will continue to do bring this issue to light in hopes to not only raise awareness but convince people to protect themselves. We have a responsibility to do what is necessary to protect ourselves and others from skin cancer, especially when we can largely PREVENT it. The first step is proper education about skin cancer prevention. And the first step in preventing skin cancer (or, at least, significantly reducing our risk) is protecting our skin from over-exposure to damaging, even carcinogenic (cancer-causing) ultraviolet radiation. In turn, one of the most effective methods of protecting our skin from UV exposure is proper year-round use of a quality sunscreen.

Summarily, I'm not saying that we must become hermits and avoid going outdoors. I was raised in Southern California, and now live in Utah -- two places that enjoy the sun and outdoors. (Incidentally, two places with high incidences of skin cancer). I am saying, however, that we must be smart and SAFE about the sun (and avoid tanning beds) by properly protecting our skin from ultraviolet radiation. Perhaps, it is easier said than done. Or, perhaps, we need to be willing to take the proper precautions; to see skin cancer as a real disease that can kill (just like any other cancer) and that we can, perhaps, save someone from having to die from it -- even ourselves.

Keep those questions, comments, and emails coming, folks. I enjoy hearing from you. It helps me be a better skin cancer educator; to know what topics to discuss on the Blog, how to develop effective educational messages and tools, and better serve both the skin cancer community, as a whole, and most especially - YOU.

Your SunSavvy friend and advocate,
Danielle & The Cancer Crusaders Organization

"I use sunscreen everyday and always recommend it to my patients."
- Dr. Roger Ceilley,Iowa dermatologist
and past president of the American Academy of Dermatology


(Note: You can learn more about ultraviolet radiation and see graphics illustrating the aforementioned concepts in my book ONLY SKIN DEEP? An Essential Guide to Effective Skin Cancer Programs and Resources).

How YOU can help someone fight melanoma

Our friends and colleagues at the Melanoma International Foundation asked us to help raise money for melanoma patients in need of care, treatment, and support.

Many insurance companies do not cover melanoma skin cancer surgery or treatments, and if you have ever had a loved one battle cancer you know the devastation chemo can cause physically, emotionally, and even financially.

That said, The Cancer Crusaders Organization is helping the MIF raise money to provide support for families touched by melanoma--the most aggressive and deadliest form of skin cancer.

Please take a few seconds to read the story they just emailed me, and consider lending your support:

"Joe* and Mary* are two teachers in their thirties with three young children (pictured above). They never dreamed that they would be dealing with a serious illness in the prime of their lives. Joe was diagnosed with stage IV melanoma and immediately found himself in the fight of his life. After dealing with various chemo regimens locally, he wasn’t getting better. His best chance for the state of the art treatment options was to go to a top melanoma treatment center, a plane trip away. His wife called the hotline and discussed available treatments and how to make Joe’s fight worthy of their efforts. A hotline staffer at the Melanoma International Foundation listened to Mary’s fears and offered her comfort and support. Within days, arrangements were made for a flight to match his appointment at the treatment center and a comfortable hotel room nearby was booked. Joe is now equipped with the best resources to fight his disease and his specialist is working with the local oncologist to try another approach to fight his melanoma. Just as important, Joe and Mary have found constant support at MIF to answer their questions, listen to their fears and work with them as they travel on this difficult journey."


Regardless of your budget, you can make a difference for these patients. Please review the information below and see if any of the tax deductible donation levels match your ability to help us help others.


$10.00 - Gives a patient or family member a complimentary Skin Cancer Awareness pin courtesy of The Cancer Crusaders Organization.

$30.00 - Gives a newly diagnosed melanoma patient a complimentary copy of Catherine Poole's book Melanoma: Prevention, Detection and Treatment (2005 Yale University Press)courtesy of the MIF.

$45.00 - Gives a patient's family a supply of Blue Lizard Australian Sunscreen courtesy of The Cancer Crusaders Organization.


$50.00 - - Gives a newly diagnosed melanoma patient, in addition to Poole's book, complimentary copy of the special edition version of ONLY SKIN DEEP? An Essential Guide to Effective Skin Cancer Programs and Resources by Danielle M. White (which originally debuted #2 on Amazon.com in March 2007) coming soon through The Cancer Crusaders Organization.

$60.00 - Covers a weeks worth costs of maintaining a 24/7 live patient support hotline via the MIF.

$400.00 - Covers a patient's flight to treatment and one nights hotel stay courtesy of the MIF.

$600.00 - Full patient sponsorship through the MIF.


Please send your tax-deductible charitable contribution to:

The Cancer Crusaders Organization
PO Box 2076 Provo, Utah 84603

(Note: In the memo box, please specify "Patient Support" and we will make sure your donation is earmarked and delivered accordingly).

You can also contact the MIF directly at info@melanomaintl.org to inquire about their specific programs, such as the Patient Support Program.

Thank you for support! Every bit helps saves lives from this deadly, but PREVENTABLE disease!

Yours in the fight,
Danielle M. White
The Cancer Crusaders Organization

PS: Please note that any of the items that read "courtesy of" are items offered specifically through that particular organization. All donations for the MIF Patient Support Program will be given to the MIF for that expressed purpose. For questions about how The Cancer Crusaders Organization is helping the MIF raise funds for patient care/support, please send an email to info@cancercrusaders.org. Thank you, and remember to be SunSavvy!

Ban the Tan!

Yes, folks, I am, once again, revisiting the subject of indoor tanning; the dangers associated with tanning and the subsequent increase of melanoma skin cancer among women in their 20s and 30s. It is a subject I’m passionate about (and, besides, this is a Blog about skin cancer prevention).

I received an email from the Environmental Protection Agency (EPA) recently that included an article that headlined "Palm Beach Tan® In-Lobby Video, 'Life Needs Color', Wins Two Prestigious Telly Awards". My initial reaction was disbelief - We are applauding indoor tanning and encouraging its use? WHAT?! Granted, the awards were given likely based on advertising creativity and commercial broadcasting. Nevertheless, the fact we are promoting the use of tanning beds without taking into consideration the dangers associated with it is, to me, not only irresponsible but perhaps even morally questionable. Is it not unethical to perpetuate the illusion of a “safe tan” when, in fact, it is biologically impossible to achieve a “safe tan”? Regardless of whether or not a tan is considered ideal, it doesn’t mean that it is safe. Because, well, it’s not safe. In fact, it’s quite the opposite. A tan is your skin's way of saying "I have sustained damage"; therefore, tanning is dangerous.

I am suddenly reminded of a 15-year-old girl who, during a public meeting in Northern Utah last year (when discussing legislation to limit minors' use of indoor tanning beds) unabashedly exclaimed:

“It's my right be tan [...] At least I will die beautiful!"

(I could not help but think, “It’s your right to die young?”)

Truth be told, not everyone who has used a tanning bed will be diagnosed with melanoma skin cancer. Yet, it is a FACT that exposure to ultraviolet radiation, over time, has cumulative effects including weakening of the elasticity in your skin, expedited aging and wrinkling and freckling, weakening of the immune system and MELANOMA. In fact, ultraviolet radiation has been identified as a known carcinogen, meaning that it’s cancer-causing. UV rays have cumulative effects on a variety of biological systems one of which is a heightened propensity toward developing melanoma – the deadliest form of skin cancer.

After working with the skin cancer community over the past several years, and teaching thousands of high school and college students, it never ceases to frighten me when I hear statements such as the one above; to learn that many young adults really don't think that skin cancer is a serious health concern not to mention that it can actually kill.

I am reminded of Charlie Guild. Charlie was 24 and preparing to go to medical school when she succumbed to malignant melanoma. Her mother, Valerie, with whom I worked on getting legislation regulating minors' use of tanning beds passed here in Utah (Valerie really championed this bill, which passed earlier this year), once told me: "I can still remember hearing Charlie tell her friends 'it's just skin cancer [...] no one really dies from skin cancer'." Well, Charlie had been diagnosed with the deadliest form of skin cancer -- melanoma, which is known as one of the most aggressive forms of cancer.

Often, when I'm giving a skin cancer presentation or hosting a training seminar, I mention melanoma warriors such as Charlie, Colette, and Scarlet -- bright and beautiful young women who, like me, were in their 20s but melanoma came and them of their future. I also share the stories of melanoma survivors such as 24-year-old MaryAnn Gerber and Brittany Leitz, the former Miss Maryland, and former professional body-building-turned-five-time-melanoma-champion Robin Lawrence. Robin, who lives in fear she won't see her daughter graduate high school, has spoken candidly about her quasi love affair with tanning beds while in her 20s, and how that cumulative exposure to ultraviolet radiation has contributed to hundreds (and counting) of biopsies.

“The question I kept asking myself was 'Why me?’” Lawrence says. "After looking back on my life, I realized I had only myself to blame. But I can honestly say that when I was growing up, I knew very little about the dangers of tanning or the threat of skin cancer. It's so ironic that my pursuit of a healthy, active lifestyle was what would eventually come back years later to threaten my life." (Learn more about Robin in ONLY SKIN DEEP? An Essential Guide to Effective Skin Cancer Programs and Resources.)

I think about these young women, who thought tanning was safe, and have since had a brush with an aggressive and lethal (but preventable) cancer. I share their stories with other young adults while giving a seminar on skin cancer prevention, sun safety, and skin care. Yet, I wonder how much of this information actually sticks; how much of it stays with my students? I can see their shock and sorrow when they see pictures of these melanoma warriors (such as Joanne pictured above) and even cry when they hear about the struggle and tragedy these melanoma warriors faced. Yet, I wonder how long those feelings last. They are reconsidering using a tanning bed now, because the image of this woman who has battled melanoma and the story of a 28-year-old mother of brand-new baby have touched their hearts and opened their eyes, but will they remember? Will it be enough to change their behavior?

I wonder –

What’s it going to take to convince people? I realize that people have a choice, but if I could effectively emphasis the seriousness of this disease; that it is preventable, but we must take proactive steps to try and protect ourselves from it and, if we don’t, we pay the ultimate price – an untimely death. If only I could bridge the gap between awareness and action; how do I make young people realize that tanning isn’t worth the risk?

These are a few (of the many) questions I wrestle with each day as I strive to develop new, more effective ways of teaching skin cancer prevention.

Generally, I prefer not to use scare tactics; rather utilize the personal touch and focus on real people, their emotions, their values, and their relationships. Hence, I share the stories of real people who have suffered melanoma and their personal battles with this horrible, devastating (yet PREVENTABLE) cancer.

However, I remember how the pictures of disfigured melanoma patients dramatically affected one particular young woman during a skin cancer prevention I hosted with Dr. Glen Bowen of Huntsman Cancer Institute last year –

As a former pageant girl, I invited the then Miss Utah Julia Bachison (a good friend of my co-founder, Natalie Johnson-Hatch, also a former Miss Utah) to be our Mistress of Ceremony; our event hostess. In addition to giving a presentation on skin cancer, we also celebrating the passing of a piece of legislation regarding sun safety education here in Utah, and wanted the "Queen of Utah” to kick off our event. Julia was gracious enough to stay for the entire event and listen to Dr. Bowen's presentation on skin cancer -- a presentation that squelched any desire she had to use a tanning bed again. Dr. Bowen's presentation featured pictures of patients who, because of skin cancer, suffered severe disfiguration. Many of these patients used tanning beds and the cumulative of ultraviolet radiation led to a battle with skin cancer. One patient lost an eye due to ocular melanoma. It broke my heart to know that so many of these people could have avoided a brush with melanoma, if only they knew about proper sun safety, the dangers of tanning, and the importance of dermatologic health. Julia, on the other hand, reacted somewhat differently to these "graphic" photos. She shuttered and gasped at the sight of these patients, even buried her face into my shoulder and vowed "I will never use a tanning bed again!" Julia was scheduled to compete at Miss America the following week, where the golden bronze look is coveted. Yet, Julia chose to follow in the footsteps of her friend and mentor - her favorite Miss Utah Natalie Camille Johnson the Skin Cancer Crusader who went to Miss America without tan. Julia did sport the bronze courtesy of a sunless tanning mousse, not a tanning bed, and won the preliminary Lifestyles and Fitness Award. The images of real people suffering from a real disease - PREVENTABLE cancer - had a profound and lasting effect on Julia. She was convinced that tanning is, in fact, dangerous; she realized that it is certainly not worth sporting a so-called "healthy glow" to put herself at risk for cancer. As Julia put it:

"It is ultimately self-defeating. You're tanning to look good, but it can later cause premature aging and, if you're diagnosed with skin cancer it can cause severe disfiguration and even kill you!"

And that's the bottom-line. Tanning does increase one's risk for melanoma skin cancer and melanoma can – and does – kill. In fact, melanoma kills another person in the U.S. every hour.

BUT IT IS PREVENTABLE!!!

Sometimes I feel like a broken record, but it is important to emphasize and re-emphasize that skin cancer is PREVENTABLE. Personally, my stream of logic is: If you can eliminate (or significantly reduce) your risk for cancer than by all means do it, especially when the preventative measures are as simple as: AVOIDING TANNING BEDS, along with monthly self-skin exams; annual visits to the dermatologist; regular (and proper) daily use of sunscreens throughout your life all-year-round; wearing UV protective wrap-around sunglasses, wide-brimmed hats, and protective clothing.

Is it that it's just too simple? Or is it the media inundating us with misinformation, misnomers and myths, and other mixed messages that has created a lingering cloud of confusion and disillusionment, thus making light of a very serious – and growing – issue? If so, may I suggest that youth who remain undeterred in their quest for coveted bronze-skin, to consider the source of the information you hear regarding tanning. Your board-certified dermatologist who went to medical school will tell you that there is no such thing as a safe tan. Yet, the tanning industry will use phrases such as "tanning in moderation" or "tan responsibly", which are minor attempts at issuing warnings without admitting the dangers outright. The only way to tan responsibly is to NOT TAN! Tanning beds are not viable tool for treating acne or Seasonal Affective Disorder, or any other condition. They are dangerous. The cumulative effects can lead to melanoma. So, why risk it? If simply must heed to your inner desire to surrender to the unrelenting pressure to look like Lindsey Lohan, then use a quality sunless tanning mousse - it won't cause premature aging and it certainly won't put you at risk for a lethal skin cancer.

Occasionally, I will receive an email from someone who accuses of me of being antagonistic toward the indoor tanning industry. And if I have been antagonistic, I apologize. Let us not fight fire with fire. If we attempt to fight extinguish a grease fire with water, we will only get burnt. (No pun intended).

I will never forget an email I received three years ago, from a tanning salon owner, who highlighted an excerpt from a newspaper article featuring my dear friend/co-founder's brother who, at age 21, succumbed to complications associated with a malignant melanoma. In the email they said, "The doctors killed him not the melanoma". In an attempt to deter me from discussing the dangers of tanning, I was heartbroken to read those malicious words but I was swayed; rather I was reminded that I have a great deal of work to do with regard to skin cancer prevention education. We all do.

In truth, this is not about playing sides or making anyone look bad; to attack the indoor tanning industry. This is not about hampering or hindering one's ability to make a living and run a successful business. I'm a big proponent of the entrepreneurial spirit. [Yet,]I'm an even bigger proponent of protecting and serving people; improving their overall quality of live. As the Hippocratic oath states "o practice and prescribe to the best of my ability for the good of my patients, and to try to avoid harming them" I will do what I can to help protect people, especially youth, from a preventable cancer. I’m not a doctor, but I am fiercely loyal to the dermatologists who strive all day, every day to protect their patients from skin cancer, and I remain dedicated to teaching people about it. Part of the rent I pay here on this earth is to serve others and this is one of the ways I try to serve. May I serve well, God-willing, and perhaps touch someone's life for the good.

Yours in the fight against skin cancer,
Danielle

Protecting Our Skin - Where do you stand?

The FDA has been sauntering on the issue of sunscreen regulation for nearly 30 years. Yet, the Environmental Protection Agency recently sent an email blast to members of its SunWise program that included a news report mentioning the FDA is finally moving closer toward an official position on monitoring sunscreen manufacturers. (Can we say, "It's about time?")

Granted, with any talk of regulations comes controversy. This ought not surprise me. The cosmetics industry fears that their interests may be crimped or hindered and retail stores worry how this may effect them, as well. In truth, however, it is absolutely vital and essential that FDA have a recognized and universally acceptable standard by which sunscreens are measured, thus providing consumers with effective protection against both UV-A and UV-Br rays, as well as accurate and clearly understandable information and, in turn, peace of mind. After all, the Australian government has issued standards regarding sunscreens. They require that sunscreens have [minimum] 5% titanium dioxide and [minimum] 5% zinc oxide so as to provide optimal broad-spectrum protection against ultraviolet radiation. So, why shouldn't the United States have standards on sunscreen, especially since melanoma -- the deadliest form of skin cancer, kills another American every 68-minutes. And, isn't it the job of the FDA to establish guidelines and standards to protect the consumers; to hold companies accountable to their consumers?

That said, I recently came across an interesting comment written by Amanda Hanley of Massachusetts regarding this very issue:

"Chief Justice John Roberts doesn't believe sunscreens need to be regulated. Apparently he has all the protection he needs -- we hear those robes offer excellent skin cancer prevention.

In the 29 years that the FDA has been wavering on sunscreen regulations, the cosmetics industry has used some pretty crazy tactics to prevent them from passing. In 2001, for example, they hired a lawyer to threaten a lawsuit. The proposed regulations, the lawyer argued, violated the first amendment.

In 2005, that lawyer took his seat as Chief Justice of the Supreme Court of the United States of America.

That's right. As recently as 2001, Justice John Roberts was lobbying on behalf of the cosmetics industry -- a fact he failed to disclose during his hearings. Not only was Justice Roberts lobbying for the cosmetics industry, but he successfully blocked regulations that may have prevented countless cases of skin cancer.

And this is the man running our Supreme Court. Doesn't it just make you feel all safe and cozy?

Hopefully, without Roberts defending them this time around, the cosmetics industry won't be able block the FDA's recently proposed sunscreen regulations. In the meantime just follow Roberts' lead for skin cancer prevention: stay inside and swing decisions to the right."


While I generally refrain from mixing politics with skin cancer crusading (skin cancer prevention ought to be about protecting people from harm, not about politics), I must admit that it baffles me to hear that a public servant, a community leader would be opposed to supporting measures that protect people and their health. Then again, when collaborating with other skin cancer crusaders on behalf of regulating minors' use of tanning beds we encountered opposition there, as well. (Thank you to Senator Pat Jones who helped pass legislation here in Utah).

Needless to say, do you know where your leaders stand on issues related to skin cancer prevention, tanning beds, melanoma research, insurance and patient care, sun safety education, and sunscreens?

If you support the FDA in its efforts to ensure consumers - YOU - will have quality sunscreens that provide optimum protection, require that sunscreen manufacturers adhere to strict standards of quality and truth in advertising, and would like to know that you are "getting what you pay for", then I encourage you make your voice heard. Speaking up about issues that are near and dear to you is not being obnoxious or contentious as some of my students may sometimes think; rather, it is part of raising awareness for a growing yet unnecessary epidemic -- skin cancer.

Let us not engage in a battle of wits, per se, and become entangled among legal jargon/rhetoric regarding whose self-interests are at stake. Quite frankly, I believe that sunscreen regulations would actually benefit all involved -- the cosmetics industry, retail stores and distributors, as well as consumers. It is in everyone's best interests to have regulations regarding quality sunscreens. And, truth be told, the real bottom-line is about taking steps to protect people from skin cancer. With 1.3 million Americans diagnosed with skin cancer every year, and 90-95% of those being preventable with proper sun safety precautions (such as the proper and year-round use of a SPF 15 broad-spectrum sunscreen) this issue is too important to be lost amid politics and special interests.

Two years ago, while at a dermatology conference, I had the pleasure of engaging in a conversation with a woman from the Cosmetics Toiletries and Fragrances Association and a gentleman from Neostrata about ingredients used in sunscreens. It is interesting to note what different industry members have to say regarding this matter. In sum, nearly all credible skin care companies, along with skin cancer educators and health advocates, agree that to wait 30 years for FDA regulations regarding quality sunscreens is ridiculous. We simply cannot afford to delay action on this issue. The subject of choosing an effective sunscreen and how to maximize sunscreen efficacy is an issue I am passionate about. If you share that passion, I encourage you share your thoughts with the FDA. Another day that passes, another 24 Americans succumb to melanoma -- the deadliest form of skin cancer.

Yet, skin cancer is PREVENTABLE! So, let us do all we can to work together to prevent it where/when possible. This is about saving lives from a growing yet unnecessary epidemic, right? Therefore, I encourage you to research this issue further, and to be proactive about proper sun safety and dermatologic health.

Constantly Crusading,
Danielle & the Cancer Crusaders

PS: Huntsman Cancer Institute conducted an evaluation of all the sunscreens on the market, studying their ingredients and cost-per-ounce. For more information, contact the Tom C. Mathews Jr. Familial Melanoma Research Clinic at HCI. You can also check out the sunscreen database.